Tracheostomy operation one-year prospective study

Prospective study of the tracheostomy operations that have been done at Mosul Teaching Hospital, Iraq. We evaluate 80 tracheostomy operations performed in the period from October 2007 to September 2008. Out of 80 patients, 56 were males [70%] and 24 were females [30%]. The age of patients ranged from 6 months to 86 years. Upper airway obstruction was found to be the commonest indication for tracheostomy [60%] and malignancy of the larynx was the predominant single cause of the upper airway obstruction. Elective tracheostomy was performed for 43 patients [53.75%] while emergency tracheostomy for 37 patients [46.25%]. Local anaesthesia was used in 43 patients [53.75%] while general anaesthesia was used in 37 patients [46.25%]. The most common complication was wound infection forming [38.09%] of all complications. More than half of the patients for whom tracheostomies done were below the age of fifty years. Upper airway obstruction is the most common indication for tracheostomy followed by assisted ventilation. Elective tracehostomy dominates over emergency one. There is a significant statistical difference between elective and emergency operations with respect to the complications. There is no significant statistical difference between local and general anaesthesia with respect to the complication. Wound infection is the most common complication encountered in this study

Post tonsillectomy bleeding a review of 500 cases

To study the incidence of bleeding following tonsillectomy, its relation to age and sex, and the effect of different hemostatic techniques on the occurrence of bleeding. Five hundred tonsillectomies were performed in the ENT department at Al Zahrawi Teaching Hospital in Baghdad, over seven years. The incidence of post tonsillectomy bleeding and the effect of age, sex, method of hemostasis and time of bleeding were studied. The incidence of major post-tonsillectomy bleeding was 1.4%, and there was an increased incidence in patients over the age of twenty. Secondary bleeding was more common in females. Eighty percent of reactionary bleeding happened in the first six hours after surgery, and most of secondary bleeding occurred toward the end of the first week. We noticed increased severity of pain prior to secondary bleeding in a number of cases. Tonsillectomy is the most commonly performed surgical procedure. Careful assessment of patients must be performed, especially in females older than twenty in whom the frequency of bleeding is higher, possibly due to a hormonal effect. The increase in the intensity of pain a few hours prior to the onset of bleeding may give a warning to start therapy that may abort the bleeding

Canal wall down mastoidectomy and causes of failure review of 25 patients

To study the causes of failure [canal wall down] mastoidectomy procedure. A prospective case series study. ENT department, Al-Jamhory Teaching Hospital during the period of May 1996 to May 2000. Twenty five patients underwent canal wall down operation over a period of four years. They were reviewed for the final result after the operation. Fifteen patients were noticed to have complete dryness and healing. Eighty percent of the patients get dry ear within the first three months after the operation. Failure to get healed cavity was seen in patients with large cavities, high facial ridge and inadequate meatoplasty. Recognition of the possible causes of failure to get dry ear, the surgeon's experience and the regular follow up of the patient, may help in achieving better results

Hoarseness in Iraqi patients. Causes and management

this study was designed to determine the causes of hoarseness in a group of Iraqi patients and to document the influence of smoking and vocal abuse in the development of laryngeal pathologies. one hundred and sixteen patients presenting with hoarseness were evaluated at Al Zahrawi Teaching Hospital during the period from September 2000 to August 2001. there were 68 [58.6%] males and 48 [41.4%] females. The average age was 40 years. Cancer of the larynx was the most common cause of chronic hoarseness [38.8%], while acute laryngitis was the predominant diagnosis in acute hoarseness [64.5%]. Overall cancer of the larynx was the most frequent diagnosis being diagnosed in 33 [28.4%] of the patients. Smoking was found to be significantly related to the development of cancer of the larynx [p<0.001] and chronic laryngitis [p<0.05]. Vocal abuse had a significant relationship with the development of chronic laryngitis, vocal cord nodule, and Reink's edema. malignancy is an important cause of chronic hoarseness in Iraqi patients. Smoking is an important risk factor for malignancy. Smoking and vocal abuse are important risk factors in the development of hoarseness

Direct laryngoscopy: a prospective study

Prospective clinical analysis of direct laryngoscopic procedures performed in Mosul Teaching Hospital Iraq. Patients and 100 direct laryngoscopic procedures performed in the period from September 1996 to June 1997. There were 55 males and 45 females. The average age was 42.8 years. The most common surgical indications were hoarseness [77%] and tumor-like mass detected on indirect laryngoscopy [38%]. Laryngeal squamous cell carcinoma [SCC] was the most common final diagnosis in the malignant cases. Chronic nonspecific laryngitis was the most common benign diagnosis. The diagnostic accuracy of indirect mirror laryngoscopy compared to direct laryngoscopy was 61%. The diagnostic accuracy of direct laryngoscopic findings and histological diagnosis was 87%. Direct laryngoscopy was difficult in 3 patients, those with short and muscular neck structure. The incidence of major complications was at least 4%. Minor complications occurred in 7% of the patients. Laryngospasm was significantly higher in patients who underwent direct laryngoscopy along with other procedures than in those who underwent direct laryngoscopy alone. Conclusions: Direct laryngoscopy was performed most often indicated for chronic hoarseness and tumor-like masses detected on indirect laryngoscopy. Laryngeal SCC was the most common malignancy and chronic nonspecific laryngitis was the most common non-malignant finding. The incidence of major complications was 4%. Laryngospasm was significantly higher in patients who had undergone procedures in addition to direct laryngoscopy. It is felt that patients who undergo direct laryngoscopy are most safely managed as in patients for 24 hours